[青少年神经源性胸廓-出口综合征手术后的长期疗效]。

IF 0.4 4区 医学 Q4 SURGERY
Andreas Pfnür, Gregor Antoniadis, Christian Rainer Wirtz, Maria Teresa Pedro
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引用次数: 0

摘要

背景:神经源性胸廓出口综合征(nTOS)是由于上胸廓出口处的神经结构受到压迫而引起的综合症状。典型症状包括受影响肢体的疼痛、麻木和运动无力。nTOS 的发病率为每十万人中 2-3 例,25 至 40 岁之间发病率最高。目前只有少数研究对青少年患者的 nTOS 手术效果进行了评估。材料和方法:在一项对 2002 年至 2021 年期间在本诊所接受手术治疗的 nTOS 病例的回顾性研究中,纳入了 8 例 15 至 18 岁的患者。研究评估了人口统计学数据、风险因素、临床症状、临床功能测试、神经生理学、放射学和术中发现。术后数据采用标准化问卷进行记录。通过锁骨上入路对下截神经、C8和Th1神经根进行了减压:手术前的平均症状持续时间为两年。在接受手术的八名患者中,有六名回答了书面调查问卷,可以进行研究分析。平均随访时间为九年(1-18 年)。手术后,所有患者的疼痛都有所减轻;其中三人长期无痛,五人不再需要止痛药。所有患者的力量都得到了改善,但有两名患者仍有轻微的运动障碍。所有患者的感觉障碍都有所减轻,但仍有五名患者存在残余感觉减退。在高空作业方面,半数患者在术后没有受到任何影响。所有患者在接受调查时都能工作。结论:青少年 nTOS 是一种罕见的压迫综合征。结论:青少年 nTOS 是一种罕见的压迫综合征,采用锁骨上入路对臂丛下部进行减压,但不切除第一根肋骨,是一种适当的治疗方法。这项回顾性研究显示,所有患者的疼痛都有所减轻。部分患者仍存在轻微的感觉和运动障碍,高空作业也受到一定限制。患者可以重返运动场。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Long-Term Outcomes after Surgery of the Neurogenic Thoracic-Outlet Syndrome in Adolescents].

Background: Neurogenic Thoracic Outlet Syndrome (nTOS) describes a complex of symptoms caused by the compression of neural structures at the upper thoracic outlet. Typical symptoms include pain, numbness and motor weakness of the affected extremity. The incidence of nTOS is 2-3 per 100,000 and is highest between the ages of 25 and 40. There are only a few studies evaluating the surgical outcomes of nTOS in adolescent patients. In particular, there is a lack of long-term data.

Materials and methods: In a retrospective study of nTOS cases receiving surgical treatment in our clinic between 2002 and 2021, eight patients between 15 and 18 years of age were included. Demographic data, risk factors, clinical symptoms, clinical functional tests, neurophysiological, radiological and intraoperative findings were evaluated. Postoperative data were recorded using a standardised questionnaire. Decompression of the inferior truncus and the C8 and Th1 nerve roots was performed via a supraclavicular approach.

Results: The average duration of symptoms before surgery was two years. Of the eight patients who underwent surgery, six answered the written questionnaire and could be analysed for the study. The average follow-up was nine years (1-18 years). After surgery, all patients experienced pain reduction; three were pain-free in the long run and five no longer required pain medication. Strength improved in all patients, but two patients still had mild motor deficits. Sensory disturbances were reduced in all patients, but residual hypoesthesia persisted in five. With regard to overhead work, half of the patients had no impairment after surgery. All patients were able to work at the time of the survey. Half of the patients pursued their sports activities without impairment, while mild impairment was reported by the other half.

Conclusion: nTOS in adolescents is a rare compression syndrome. Decompression of the lower parts of the brachial plexus using a supraclavicular approach without resection of the first rib is an adequate treatment. This retrospective study showed that a reduction in pain was achieved in all patients. In some patients, slight sensory and motor disturbances as well as a certain restriction in overhead work persisted. Patients were able to return to sports.

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来源期刊
CiteScore
1.00
自引率
16.70%
发文量
85
审稿时长
6-12 weeks
期刊介绍: In Originalarbeiten und Fallberichten finden Sie die neuesten Informationen über: Diagnostik Verfahrenswahl state of the art / neueste Techniken rekonstruktive Verfahren Behandlung infolge von Traumata oder OP Bewertung der Ergebnisse Klinische Forschung Interessante Darstellung der neuesten Erkenntnisse in Originalarbeiten und Fallberichten. Exzellent veranschaulicht durch ein klares Layout und reiche Bebilderung. Überzeugen Sie sich selbst! Organschaften Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie, Deutschen Gesellschaft für Handchirurgie und Österreichischen Gesellschaft für Handchirurgie Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße Organ der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen
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